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The e-mémoires of the Académie Nationale de Chirurgie

Adults inguinal hernia repair by plasty using the large oblique muscle aponevrose: Desarda’s technique

TOURE A | TOURE CT | DIENG M | DIA A | KONATE I | KA O | CISSE M | SECK M | DIALLO F

Seance of wednesday 09 may 2012 (pas de sujet Principal)

Abstract

Aim. To report our experiment of the use of Desarda’s technique, which consists on a plasty using the large oblique muscle aponevrose, in the treatment of inguinal hernias.Patients and methods. It is about a prospective study go to March 2009 to March 2011, concerning 100 cases of inguinal hernias among 94 patients operated by Desarda’s technique at the Department of General surgery of the University hospital Aristide Le Dantec of Dakar. They were 88 men (94%) and 6 women (6%) with an average age of 44.7 years. The studied parameters were the operational data, the postoperative pain and the recurrence.Results. The hernia was indirect in 71% of the cases, direct in 25% of the case and mixed in 4% of the cases. The acute postoperative pain was absent among 62 patients (66%). The evaluation of the pain beyond the third month show four cases of light chronic pain (EVA<2). Postoperative complications were noted among 11 patients (11.7%): most frequent was wound infection (4 cases [4.3%]), followed by acute retention of urines (3 cases [3.2%]), scrotal hematoma (2 cases [2.1%]) and vomiting (2 cases [2.1%]). No recurrence was noted in our study, the mean follow-up period was 17 months with extremes of 3 and 27 months.Conclusion. The aponevrotic plasty of the large oblique according to Desarda constitutes a reliable and inexpensive alternative to the treatment using prosthesis in the management of inguinal hernias; however, a longer follow-up period could allow assessing its real efficiency.